| 摘要: |
| 目的:探讨渐进式功能锻炼在肱骨远端C 型骨折双钢板内固定术后对肘关节功能影响。方法:对纳入标准的80例肱骨远端C 型骨折患者均给予双钢板内固定术，术后随机分为治疗组和对照组各40 例，治疗组术后即可给予渐进式功能锻炼；对照组术后患肢于伸肘30°位石膏外固定制动，1 周后(术后7~11 天)开始功能锻炼。采用肘关节Mayo 评分、肘关节活动度比较2 组术后2 周、术后3 月、术后6 月肘关节功能，并对术后6 月并发症进行对比。结果:80 例均获得随访，治疗组和对照组术后3 月、术后6 月肘关节疼痛、活动度、稳定性以及日常生活活动能力与术后2 周比较，差异均有统计学意义(P <0.05)；术后3 月、术后6 月治疗组肘关节疼痛评分均高于对照组(P ＜ 0.05)；治疗组和对照组术后3 月、术后6 月肘关节屈曲度、肘关节伸直差值度、前臂旋前度及前臂旋后度与术后2 周比较，差异均有统计学意义(P <0.05)；术后3 月、术后6 月治疗组肘关节屈曲度，肘关节伸直差值度，前臂旋前度，前臂旋后度均高于对照组(P ＜ 0.05)；术后3月两组优良率经Wilcoxon 秩和检验(Z = –1.976，P ＜ 0.05)；术后6 月两组优良率经Wilcoxon 秩和检验(Z = –2.042， P ＜ 0.05)；2 组术后6 月均无出现切口感染及血管神经损伤，术后总并发症比较差异无统计学意义(P ＞ 0.05)。结论:肱骨远端C 型骨折双钢板内固定术后早期渐进式功能锻炼在肘关节活动度、功能恢复、疼痛缓解方面具有明显优势，且安全可靠。 |
| 关键词: 肱骨远端C 型骨折 双钢板 内固定术 渐进式功能锻炼 |
| DOI：10.3969/j.issn.1007-6948.2020.02.028 |
| 投稿时间：2019-01-28 |
| 基金项目:石家庄市科学技术研究与发展项目(131462513)；河北省医学科学研究项目(ZL20140288) |
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| Effect of Progressive Functional Exercise on Double Steel Plate Internal Fixation of Distal Humerus C Type Fracture |
| TIAN Yu-liang,YU Hai-quan,Cao Bin |
| The Third Department of Orthopaedics, Shijiazhuang First Hospital, Shijiazhuang 050011, China |
| Abstract: |
| Objectives To investigate the effect of progressive functional exercise on elbow joint function after double steel plate internal fixation for distal humerus C type fractures. Methods Eighty patients with distal humerus C type fractures that accorded with the inclusion criteria treated with double steel plate internal fixation were selected and randomly divided into treatment group and control group after operation (n=40). After operation, the patients in treatment group were given progressive functional exercise. In the control group, the affected limb was fixed and braked at the position of 30° elbow extension, and functional exercise was started one week later (7–11 days after operation). Elbow joint function was compared between the two groups 2 weeks,3 months and 6 months postoperatively by elbow joint Mayo scale; the elbow range of motion and complications 6 months after surgery were compared. Results All the 80 patients were followed up, the treatment group and control group in elbow joint pain, activity, stability and ADL ability were significantly different between 3 months and 6 months after surgery and 2 weeks after surgery (P <0.05); the pain scores of the elbow joints in the treatment group were higher than those in the control group at 3 months and 6 months after operation (P <0.05);The treatment group and control group in elbow flexion, elbow extension, forearm pronation and forearm curl were significantly different between 3 months and 6 months after surgery and 2 weeks after surgery (P <0.05). The elbow flexion, elbow straight difference degrees,Forearm pronation degrees and Forearm curl degrees of the treatment group 3 months and 6 months after operation were higher than those of the control group(P<0.05); 3 months after surgery, Wilcoxon rank sum test was performed on the rates of excellent and good in the two groups (Z= –1.976, P<0.05). 6 months after surgery, Wilcoxon rank-sum test was performed on the excellent and good rates of the two groups (Z= –2.042, P<0.05); No incision infection or vascular and nerve injury occurred in the two groups 6 months after surgery, and the comparison of total postoperative complications was not statistically significant (P>0.05). Conclusions Early progressive functional exercise after double steel plate internal ?xation of distal humerus C type fractures has obvious advantages in elbow range of motion, functional recovery and pain relief, which is safe and reliable. |
| Key words: Distal humerus C type fractures double steel plate internal fixation progressive functional exercise |
